Chance, Necessity, Love: A Pastoral Theology of Cancer

Course Rationale

The science on cancer is as clear and certain as it gets: this disease is one of evolutionary development. That is, cancers progress according to evolutionary principles when cells—“the very fiber of our being” in the language of a Novena to Saint Peregrine—go their own way and, thereby threaten the rest of that “fiber.” While religious perspectives, questions, and arguments abound in church and society regarding evolution in general, remarkably few struggle to make meaning of the evolutionary nature of cancer. Even rarer—and arguably more urgent—is practical theological inquiry into faithful understandings and wise practices by pastoral leaders and pastoral theologians in response to cancer as an evolutionary phenomenon.

Cancer is a disease replete with paradox. On the one hand, it touches the lives of both the more powerful and the less powerful. On the other hand, differences in cancer vulnerability do occur through occasionally inherited predisposition to the disease and through the ways that poverty and social injustice generally affect its incidence and outcome. Cancer also is a disease that may or may not be treated successfully depending on the stage of its detection and on the treatment and aggressiveness of the disease. Still, the occurrence of cancers in particular persons may be prevented through individual and social efforts, and new treatments for care and cure have been and continue to be developed. Therefore, the following assertion is puzzling but it is also quite true: cancer is something that both cannot and can be changed.

The underlying reason for this paradox is located in the nature of the disease itself: cancer evolves through the complex interplay of chance occurrences and law-like regularities that sometimes may be altered and other times not. Furthermore, just as DNA mutations and natural selection for those mutations are involved in the evolution of various species, so also mutational mechanisms and forces of selection are at work in the evolution of individual cancers. This may be said another way, with a more ironic emphasis: while physical operations of chance and necessity promote the evolution of life, so those very same forces drive the development of a disease that may destroy life.

Cancer is a disease whose origin and progression often vex and confuse cancer patients and those who care for them. Those diagnosed with the disease often struggle to understand its possible causes and future course. Family members wonder what they must accept and may hope for. Pastors hear much about cancer: newly suspected causes, new possible cures and new dangers in treatment—and then worry about and hope for their people. The evolutionary chance and necessity at work in the onset and development of cancer perplex people about what can be changed and what cannot be changed about this disease.

In our considering best pastoral practices in response to cancer, our guiding questions will be these: (1) How may God be preached, taught, and, in pastoral care, understood if the development of life and the development of cancers are linked by evolution? (2) What does pastoral wisdom look like if cancers are something that, as evolutionary phenomena, sometimes can be changed and, at other times, cannot be? (3) What are faithful and wise pastoral responses to social and economic issues generated by and in response to the evolution of cancers? The provisional answers put forth by our community of inquiry will initiate the development of a pastoral theology of cancer and evolution.

  • Course Categories: Pastoral Theology
  • Science Topics: Life Sciences
  • Seminaries: Lutheran Theological Seminary at Gettysburg
  • Syllabus: Chance, Necessity, Love: A Pastoral Theology of Cancer
  • Tags:
    evolution, pastoral theology, pastoral care, cancer, counseling, cell biology, mainline protestant, pastoral theology of cancer

Related resources

In furtherance of the AAAS mission of advancing science in service to society, AAAS|DoSER’s role in the Science for Seminaries project is to support efforts to integrate science into seminary education. AAAS|DoSER does not advise on or endorse the theological content of the participating seminaries.